Healthcare Provider Details
I. General information
NPI: 1619740230
Provider Name (Legal Business Name): SYBIL'S MOBILE HAIR SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
229 W BUFFWOOD DR
BAKER LA
70714-3755
US
IV. Provider business mailing address
229 W BUFFWOOD DR
BAKER LA
70714-3755
US
V. Phone/Fax
- Phone: 225-284-8959
- Fax:
- Phone: 225-284-8959
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
SYBIL
R
RAMSEY
Title or Position: OWNER
Credential: SPECIALIST
Phone: 225-284-8959